SHUNDRA WILSON


Address: 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681
Phone: 6019845615

SHUNDRA WILSON (NPI# 1619346822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619346822
Entity Type Individual
Full Name SHUNDRA WILSON
Credential FNP
Practice Address 350 W Woodrow Wilson Ave
Jackson
MS 39213-7681
Mailing Address 2500 North State Street
Jmm Room 2525
Jackson
MS 39216-4500
Practice Telephone 6019845615
Mailing Telephone 6019846426
Mailing Fax Number 6019846439
Enumeration Date 2015-09-17
Last Update Date 2015-12-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
R805409 MS Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MS 07900514 05

Office Location

Street Address 350 W WOODROW WILSON AVE
City JACKSON
State MS
Zip Code 39213-7681

Providers in the same location

NPI Name Taxonomy Address Enumeration
1184607210 Srinivasan Vijayakumar Radiology 350 W Woodrow Wilson Ave, Suite 16, Jackson, MS 39213-7681 2005-11-22
1487285268 Andreina Guedez Mijares Dietitian, Registered 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 2020-01-30
1114492725 Kandis Vechelle Backus Pharmacist 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 2018-10-10
1780104646 Jamie Simonson Dean Nurse Practitioner 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 2017-06-22
1730610775 Take Care Pharmacy Pharmacy 350 W Woodrow Wilson Ave, Suite 311, Jackson, MS 39213-7681 2017-03-22
1891236725 Christina Purviance Nurse Practitioner 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 2017-03-11
1265983316 Molly Sullivan Nurse Practitioner 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 2016-10-24
1982057345 Flora K. Green Nurse Practitioner 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 2016-07-20
1336521343 Karen Cathey Counselor 350 W Woodrow Wilson Ave, Suite 3572, Jackson, MS 39213-7681 2015-06-25
1255721080 Medhome Specialty Services, LLC Durable Medical Equipment & Medical Supplies 350 W Woodrow Wilson Ave, Suite 241, Jackson, MS 39213-7681 2015-02-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679117980 Cynthia Bailey Technician 916 Carnation Street, Jackson, MS 39213 2019-10-30
1871136374 Shirley Collins Williams Technician 3132 Sage St, Jackson, MS 39213 2019-10-28
1275057069 Nikita Patel Pharmacist 830 West Woodrow Wilson Avenue, Jackson, MS 39213 2017-08-02
1346782893 Mississippi Smiles Dentistry LLC Dentist 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 2016-11-15
1730637521 Ms Eyecare Associates of Jackson, Pllc. Optometrist 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 2016-09-21
1518410778 Assurance Home Health Services, LLC Health Maintenance Organization 1771 Hamilton Blvd., Jackson, MS 39213 2016-07-25
1831576180 Dorothy Jeffries Anderson Counselor 350 Woodrow Wilson Ave, Jackson, MS 39213 2015-05-06
1740697275 Sincere Home Care LLC. Chore Provider 5911 Holmes Ct, Jackson, MS 39213 2014-07-16
1629401088 Deborah Diane Wright Assisted Living Facility 5911 Holmes Court, Jackson, MS 39213 2013-08-20
1245663251 Methodist Home Road Living Center Licensed Practical Nurse 4560 Methodist Home Road, Jackson, MS 39213 2013-08-13
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073113627 Jessicah Blasdel Nurse Practitioner 113 W Michigan Ave, Jackson, MI 49201-1340 2020-10-31
1801406335 Jade Russell Nurse Practitioner 2205 W Morrell St, Jackson, MI 49203-1357 2020-08-10
1992315212 Patrecia Campbell Nurse Practitioner 2570 Bailey Ave Ste 7, Jackson, MS 39213-6905 2020-08-01
1669008926 Kristine Edwards Nurse Practitioner 723 Woodlawn Ave, Jackson, MI 49203-2921 2020-03-19
1295366391 Christy White Nurse Practitioner 363 Old Pinson Rd, Jackson, TN 38301-9576 2020-01-28
1972141620 Primary Care - Bemis, LLC Nurse Practitioner 1385 S Highland Ave Ste B4, Jackson, TN 38301-7547 2019-12-12
1174164263 Tami Anne Miller Nurse Practitioner 124 N Bast St, Jackson, MO 63755-1704 2019-10-01
1265080584 Cameron Nicole Howard Nurse Practitioner 1860 Chadwick Dr Ste 256, Jackson, MS 39204-3486 2019-08-29
1831750843 Rhiannon Michelle Andresen Nurse Practitioner 1022 Greystone Sq, Jackson, TN 38305-3580 2019-06-21
1902376361 Jenay B Krumm Nurse Practitioner 1201 E Michigan Ave Ste 200, Jackson, MI 49201-1855 2018-11-28
Find all providers in JACKSON

Competitor

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City JACKSON
Zip Code 39213

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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